超声心动图检测不同年龄川崎病患儿冠状动脉损害的研究

Detection of coronary artery lesion in different ages of children with Kawasaki disease by echocardiography

目的应用超声心动图检查不同年龄川崎病患儿冠状动脉损害(CAL)程度。方法选取经临床诊断且行超声心动图检查的川崎病患儿416例,其中并发Ⅱ、Ⅲ、Ⅳ级CAL患儿179例。根据不同年龄段分组:(1)分为2组:<5岁组131例,其中Ⅱ级CAL 75例,Ⅲ级CAL 45例,Ⅳ级CAL 11例;≥5岁组48例,其中Ⅱ级CAL 35例,Ⅲ级CAL 10例,Ⅳ级CAL 3例;应用非参数法比较2组CAL的严重程度。(2)分为3组:<3岁组70例,其中Ⅱ级CAl 40例,Ⅲ级CAL 20例,Ⅳ级CAL 10例;3~4岁组61例,其中Ⅱ级CAL 35例,Ⅲ级CAL 25例,Ⅳ级CAL 1例;≥5岁组48例,其中Ⅱ级CAL35例,Ⅲ级CAL 10例,Ⅳ级CAL 3例;应用列联表χ2检验分析不同年龄段川崎病患儿CAL严重程度的差异,并计算列联系数(CP),以显示年龄与CAL不同严重程度的关联性。结果川崎病伴Ⅱ、Ⅲ、Ⅳ级CAL的检出率为43.03%。CAL的严重程度分级比较显示<5岁组(秩均值111.06)高于≥5岁组(秩均值32.52),差异有统计学意义(Z=-0.946,P=0.000)。不同年龄段(<3岁、3~4岁、≥5岁)川崎病患儿CAL严重程度的关联性分析显示差异有统计学意义(χ2=12.00,P=0.02)。年龄与CAL严重程度呈低度关联(CP=0.25)。结论 <5岁川崎病患儿Ⅱ、Ⅲ、Ⅳ级CAL分级例数均高于≥5岁患儿,年龄与CAL严重程度分级呈低度关联。

Objective To examine coronary artery lesion（CAL）in different age of children with Kawasaki disease by echocardiography.Methods A total of 416 Kawasaki disease children were examined by echocardiography and clinical diagnosis were enrolled,179 cases of them with Ⅱ,Ⅲ,Ⅳ level of CAL were divided into two groups according to the age： 5 years old group（131 cases）,including 75 cases of level Ⅱ CAL,45 cases of level Ⅲ CAL,11 cases of level Ⅳ CAL. ≥5 years old group（48 cases）,including 35 cases of level Ⅱ CAL,10 cases of level Ⅲ CAL,3 cases of level Ⅳ CAL.Nonparametric method was applied to compare the severity of CAL between the two groups.179 cases were further divided into three groups： 3 years old group（70 cases）,including 40 cases of level Ⅱ CAL,20 cases of level Ⅲ CAL,10 cases of level Ⅳ CAL.3~4 years old group（61 cases）,including 35 cases of level Ⅱ CAL,25 cases of level Ⅲ CAL,1 case of level Ⅳ CAL.≥5 years old group（48 cases）,including 35 cases of level Ⅱ CAL,10 cases of level Ⅲ CAL,3 cases of level Ⅳ CAL.Contingency table chi-square test was used to analyze the correlation between age and the severity of CAL.Results The detection rate of Kawasaki disease with Ⅱ,Ⅲ,Ⅳlevel of CAL was 43.03%.The severity of CAL was compared between two groups,the severity of 5 years old group（rank mean111.06）was higher than ≥5 years old group（rank mean 32.52）,the difference was statistically significant（Z=-0.946,P=0.000）.Correlation analysis showed there was significant difference between different age（ 〈3 years old,3~4 years old and ≥5 years old）and severity of CAL（χ2=12.00,P =0.02）.There was mild association between age and the severity of CAL（CP =0.25）.Conclusion 5 years old Kawasaki disease children is more severe than ≥5 years old children,there is mild association between age and the severity of CAL.